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Quality Measurement and Improvement Study of Surgical Coronary Revascularization: Medication Adherence (MISSION-2)
BACKGROUND: Secondary preventive therapies play a key role in the prevention of adverse outcomes after coronary artery bypass grafting (CABG). However, medication adherence after CABG is often poor, and conventional interventions for improving adherence have limited success. With increasing penetrat...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Medknow Publications & Media Pvt Ltd
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6006808/ https://www.ncbi.nlm.nih.gov/pubmed/29873315 http://dx.doi.org/10.4103/0366-6999.233767 |
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author | Liu, Chong-Yang Du, Jun-Zhe Rao, Chen-Fei Zhang, Heng Liu, Han-Ning Zhao, Yan Yang, Li-Meng Li, Xi Li, Jing Wang, Jue Wang, Hui-Shan Liu, Zhi-Gang Cheng, Zhao-Yun Zheng, Zhe |
author_facet | Liu, Chong-Yang Du, Jun-Zhe Rao, Chen-Fei Zhang, Heng Liu, Han-Ning Zhao, Yan Yang, Li-Meng Li, Xi Li, Jing Wang, Jue Wang, Hui-Shan Liu, Zhi-Gang Cheng, Zhao-Yun Zheng, Zhe |
author_sort | Liu, Chong-Yang |
collection | PubMed |
description | BACKGROUND: Secondary preventive therapies play a key role in the prevention of adverse outcomes after coronary artery bypass grafting (CABG). However, medication adherence after CABG is often poor, and conventional interventions for improving adherence have limited success. With increasing penetration of smartphones, health-related smartphone applications might provide an opportunity to improve adherence. Carefully designed trials are needed to provide reliable evidence for the use of these applications in patients after CABG. METHODS: The Measurement and Improvement Studies of Surgical Coronary Revascularization: Medication Adherence (MISSION-2) study is a multicenter randomized controlled trial, aiming to randomize 1000 CABG patients to the intervention or control groups in a 1:1 ratio. We developed the multifaceted, patient-centered, smartphone-based Heart Health Application to encourage medication adherence in the intervention group through a health self-management program initiated during hospital admission for CABG. The application integrated daily scheduled reminders to take the discharge medications, cardiac educational materials, a dynamic dashboard to review cardiovascular risk factors and secondary prevention targets, and weekly questionnaires with interactive feedback. The primary outcome was secondary preventive medication adherence measured by the Chinese version of the 8-item Morisky Medication Adherence Scale at 6 months after randomization. Secondary outcomes included all-cause death, cardiovascular rehospitalization, and a composite of death, myocardial infarction, stroke, and repeat revascularization. DISCUSSION: Findings will not only provide evidence regarding the feasibility and effectiveness of the described intervention for improving adherence to CABG secondary preventive therapies but also explore a model for outpatient health self-management that could be translated to various chronic diseases and widely disseminated across resource-limited settings. TRIAL REGISTRATION: https://clinicaltrials.gov(NCT02432469). |
format | Online Article Text |
id | pubmed-6006808 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-60068082018-06-30 Quality Measurement and Improvement Study of Surgical Coronary Revascularization: Medication Adherence (MISSION-2) Liu, Chong-Yang Du, Jun-Zhe Rao, Chen-Fei Zhang, Heng Liu, Han-Ning Zhao, Yan Yang, Li-Meng Li, Xi Li, Jing Wang, Jue Wang, Hui-Shan Liu, Zhi-Gang Cheng, Zhao-Yun Zheng, Zhe Chin Med J (Engl) Study Protocol BACKGROUND: Secondary preventive therapies play a key role in the prevention of adverse outcomes after coronary artery bypass grafting (CABG). However, medication adherence after CABG is often poor, and conventional interventions for improving adherence have limited success. With increasing penetration of smartphones, health-related smartphone applications might provide an opportunity to improve adherence. Carefully designed trials are needed to provide reliable evidence for the use of these applications in patients after CABG. METHODS: The Measurement and Improvement Studies of Surgical Coronary Revascularization: Medication Adherence (MISSION-2) study is a multicenter randomized controlled trial, aiming to randomize 1000 CABG patients to the intervention or control groups in a 1:1 ratio. We developed the multifaceted, patient-centered, smartphone-based Heart Health Application to encourage medication adherence in the intervention group through a health self-management program initiated during hospital admission for CABG. The application integrated daily scheduled reminders to take the discharge medications, cardiac educational materials, a dynamic dashboard to review cardiovascular risk factors and secondary prevention targets, and weekly questionnaires with interactive feedback. The primary outcome was secondary preventive medication adherence measured by the Chinese version of the 8-item Morisky Medication Adherence Scale at 6 months after randomization. Secondary outcomes included all-cause death, cardiovascular rehospitalization, and a composite of death, myocardial infarction, stroke, and repeat revascularization. DISCUSSION: Findings will not only provide evidence regarding the feasibility and effectiveness of the described intervention for improving adherence to CABG secondary preventive therapies but also explore a model for outpatient health self-management that could be translated to various chronic diseases and widely disseminated across resource-limited settings. TRIAL REGISTRATION: https://clinicaltrials.gov(NCT02432469). Medknow Publications & Media Pvt Ltd 2018-06-20 /pmc/articles/PMC6006808/ /pubmed/29873315 http://dx.doi.org/10.4103/0366-6999.233767 Text en Copyright: © 2018 Chinese Medical Journal http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. |
spellingShingle | Study Protocol Liu, Chong-Yang Du, Jun-Zhe Rao, Chen-Fei Zhang, Heng Liu, Han-Ning Zhao, Yan Yang, Li-Meng Li, Xi Li, Jing Wang, Jue Wang, Hui-Shan Liu, Zhi-Gang Cheng, Zhao-Yun Zheng, Zhe Quality Measurement and Improvement Study of Surgical Coronary Revascularization: Medication Adherence (MISSION-2) |
title | Quality Measurement and Improvement Study of Surgical Coronary Revascularization: Medication Adherence (MISSION-2) |
title_full | Quality Measurement and Improvement Study of Surgical Coronary Revascularization: Medication Adherence (MISSION-2) |
title_fullStr | Quality Measurement and Improvement Study of Surgical Coronary Revascularization: Medication Adherence (MISSION-2) |
title_full_unstemmed | Quality Measurement and Improvement Study of Surgical Coronary Revascularization: Medication Adherence (MISSION-2) |
title_short | Quality Measurement and Improvement Study of Surgical Coronary Revascularization: Medication Adherence (MISSION-2) |
title_sort | quality measurement and improvement study of surgical coronary revascularization: medication adherence (mission-2) |
topic | Study Protocol |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6006808/ https://www.ncbi.nlm.nih.gov/pubmed/29873315 http://dx.doi.org/10.4103/0366-6999.233767 |
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